Healthcare Provider Details

I. General information

NPI: 1417917782
Provider Name (Legal Business Name): JAY L PILAND MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2006
Last Update Date: 01/21/2022
Certification Date: 01/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 4TH ST STE. 5A, BOX 30129
ALEXANDRIA LA
71301-8421
US

IV. Provider business mailing address

201 4TH ST STE. 5A, BOX 30129
ALEXANDRIA LA
71301-8421
US

V. Phone/Fax

Practice location:
  • Phone: 318-448-1249
  • Fax: 318-448-9644
Mailing address:
  • Phone: 318-448-1249
  • Fax: 318-448-9644

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0401X
TaxonomyAddiction Medicine (Internal Medicine) Physician
License Number022337
License Number StateLA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number022337
License Number StateLA
# 3
Primary TaxonomyN
Taxonomy Code2083A0300X
TaxonomyAddiction Medicine (Preventive Medicine) Physician
License Number022337
License Number StateLA
# 4
Primary TaxonomyN
Taxonomy Code2084P0802X
TaxonomyAddiction Psychiatry Physician
License Number022337
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: